Grzyb Chloe, Du Dongping, Mahesh Balakrishnan, Nair Nandini
Penn State College of Medicine, Hershey, PA, USA.
Texas Tech University System, Lubbock, TX, USA.
Int J Artif Organs. 2025 Jan;48(1):15-22. doi: 10.1177/03913988241305309. Epub 2024 Dec 26.
Ventricular assist device (VAD) and cardiac transplant patients experience significant strain on their physical and mental wellbeing postoperatively. Mental health and substance use disorders (MHDs and SUDs) have substantial effects on the quality of life and compliance of transplant and VAD patients. In this study, we compare and characterize MHDs and SUDs between VAD and cardiac allograft patients and transplant list patients with and without VADs. This study compares the incidence of MHDs and SUDs between VAD and cardiac transplant patients. Cohorts were defined using ICD-10 codes in TriNetX, a large public database. Patient characteristics were matched by using propensity score matching. Incidence was analyzed using the log-rank test. Statistical significance was set at < 0.05. Survival analysis showed a statistically significant impact of adjustment disorder, nicotine dependence, and mood disorder in VAD patients as compared to cardiac allograft recipients. Depression and opioid use disorder had a significantly higher incidence in post-transplant patients compared to their VAD counterparts. Survival analysis showed that PTSD and mood disorder had a statistically significant effect on the patients waiting on transplant wait list without VADs as compared to those with VADs. MHDs and SUDs have profound implications on quality of life, survival, and medication compliance. The incidence of MHDs and SUDs differed between VAD versus cardiac transplant patients as well as the patients on the transplant waitlist with and without VADs. Mental health resources should be tailored to address risk factors that may be unique to each group of patients.
心室辅助装置（VAD）和心脏移植患者术后在身心健康方面承受着巨大压力。心理健康和物质使用障碍（MHDs和SUDs）对移植患者和VAD患者的生活质量及依从性有重大影响。在本研究中，我们比较并描述了VAD患者、心脏移植患者以及有和没有VAD的移植等待名单患者之间的MHDs和SUDs情况。本研究比较了VAD患者和心脏移植患者之间MHDs和SUDs的发生率。在一个大型公共数据库TriNetX中使用国际疾病分类第十版（ICD - 10）编码来定义队列。通过倾向得分匹配来匹配患者特征。使用对数秩检验分析发生率。设定统计学显著性为<0.05。生存分析表明，与心脏移植受者相比，调整障碍、尼古丁依赖和情绪障碍对VAD患者有统计学显著影响。与VAD患者相比，移植后患者的抑郁症和阿片类物质使用障碍发生率显著更高。生存分析表明，与有VAD的患者相比，创伤后应激障碍（PTSD）和情绪障碍对没有VAD的移植等待名单患者有统计学显著影响。MHDs和SUDs对生活质量、生存率和药物依从性有深远影响。VAD患者与心脏移植患者之间以及有和没有VAD的移植等待名单患者之间，MHDs和SUDs的发生率存在差异。应量身定制心理健康资源，以应对每组患者可能特有的风险因素。
